New York State (NYS) Medicaid's Statewide Patient-Centered Medical Home Incentive Program

Chapter 58 of the Laws of 2009 authorized the New York State Department of Health (NYSDOH) to implement an initiative to incentivize the development of patient-centered medical homes to improve health outcomes through better coordination and integration of patient care for persons enrolled in New York Medicaid.

New York Medicaid has chosen to adopt medical home standards that are consistent with those of the National Committee for Quality Assurance's (NCQA) Physician Practice Connections® - Patient-Centered Medical Home Program (PPC-PCMH™). The PPC-PCMH™ is a model of care that seeks to strengthen the physician-patient relationship by promoting improved access, coordinated care, and enhanced patient/family engagement.

A medical home also emphasizes enhanced care through open scheduling, expanded hours, and communication between patients, providers and staff. Care is also facilitated by registries, information technology, health information exchange and other means to ensure that patients obtain the proper care in a culturally and linguistically appropriate manner.

The NCQA PPC®-PCMH™ program assesses whether practices are functioning as medical homes. Building on the joint principles developed by the primary care specialty societies, the PPC®-PCMH™ standards emphasize the use of systematic, patient-centered, coordinated care management processes.

http://www.health.state.ny.us/health_care/medicaid/program/update/2009/2009-12spec.htm

Questions/Information

For more information on how to achieve NCQA certification as a NCQA PPC-PCMH™, providers should contact NCQA Customer Support at (800) 839-6487, or visit the NCQA Website at http://www.ncqa.org. Since New York Medicaid is recognized as a sponsoring organization, providers will receive a 20 percent discount from NCQA toward the cost of the PPC-PCMH™ application. Questions regarding New York Medicaid's Patient-Centered Medical Home initiative may be directed to the Office of Health Insurance Program's Division of Financial Planning and Policy at (518) 473-2160.

Please contact the Bureau of Managed Care Finance at (518) 474-5050 with any questions regarding health plan medical home payments for network providers.

NYC DOH PCIP
Primary Care Development Corporation
New York eHealth Collaborative